Posts Tagged ‘“Nancy Morgan RN”’

What exactly is an ABI? ABI stands for Ankle Brachial Index. This is a non-invasive bedside tool that compares the systolic blood pressure of the ankle to that of the arm. It is done to rule out Peripheral Arterial Disease in the lower extremities. The ABI is considered the “bedside” gold standard diagnostic test and can be done by any trained clinician in a clinic, hospital, nursing home and/or even the home care setting. All you need is a blood pressure cuff and a hand held Doppler.

Why do we do the Ankle Brachial Index or ABI? Well, there are several reasons why we include the ABI as part of our assessment for the patient with lower extremity wounds. First of all, in order to heal a wound we have to be sure that our patient has adequate blood flow. The ABI will tell us if the patient has impaired arterial blood flow, and how significant that impairment is. We also need to know the amount of compression that we can safely apply to the venous patient, in general the lower the patients ABI reading, the lower the amount of compression that can be safely applied.

When do I need to do the ABI? Standards of care and Guidelines dictate when we should be doing the Ankle Brachial Index. Our current standard of practice states to do the ABI: Anytime a patient has a lower extremity ulcer, when foot pulses are not clearly palpable, prior to applying compression wraps / garments or when the lower extremity ulcer is no longer healing.

What does the ABI “number” mean? First we need to be aware that not everyone’s ABI is reliable, in fact patients with diabetes or end-stage renal disease may have incompressible vessels rendering a falsely high ABI score. For these patients we use another diagnostic test called the Toe Brachial Pressure Index (TBPI) instead of the ABI. For those with ABI readings, in general as the patients ABI score decreases, this signifies that the patient has arterial disease of the lower extremity, and poor blood flow. Any patient with an abnormal reading needs a referral to a vascular specialist. Bedside interpretations of the ABI that we use as wound clinicians are: 1.0 considered a normal reading, an ABI of 0.9 indicate more venous, 0.6-0.8 indicate a mixed etiology (venous and arterial) and less than or equal to 0.5 is indicative of arterial disease of the lower extremity.

We as wound care clinicians are held to certain standards of care and must follow those guidelines established by the experts. Performing the ABI on patients before applying compression and on patients with lower extremity ulcers is one of them. As wound clinicians we use the ABI and our clinical assessment to help guide us into determining what type of ulcer we are dealing with so we can make appropriate referrals and develop the best treatment plan for our patients. It’s a step we can’t afford to leave out; our patient’s limb may depend on it.

Congratulations to Gayle Audenried from Moab Regional Hospital in Moab Utah. She is the winner of the “Why I Want To Go To WOW” contest. Gayle receives an all expense paid trip to Las Vegas to attend the 2012 Wild on Wounds Conference at the Caesars Palace Hotel. Each participant submitted a 3 minute video telling our alumni why they wanted to go to WOW. Gayle’s video received over 400 votes. Her creativity really paid off. To view Gayle’s video click here.

We also wish to thank our other participants. Lona Gless, Andrea Hinojos and Sharon Pavelka.

Wild on Wounds Conference is being held September 12-15, 2012 in Las Vegas at the Caesars Palace. Details can be found at www.woundseminar.com.

Wounds on the Web will be presented by Nancy Morgan RN, BSN, MBA, WOCN, WCC, CWCMS, and Co-Founder of WCEI at this year’s Wild on Wounds National Conference this September 7-10, 2011 in Las Vegas.

Why do I need to be wired? There is a plethora of information available at your fingertips. You can access the standards of care, current research and products on the web. We’re going to show you how to access photos, power points, and obtain contact hours on the Internet. You’ll learn how to stay up to date, how to use social networking, and which hot links to access. We’ll discuss ways you can train your staff and patients through YouTube and we’ll help you sort out the good from the bad. So, sign up and log in to this session.

For more information about the Wound Care Education Institute, please visit http://www.wcei.net.

This session will discuss the goals of Palliative Wound Management . Our approach to wound care is less aggressive, and we encounter many challenges. We’ll discuss those challenges, which include: wound odor, excessive bleeding, exudate, necrotic tissue, pain, peri-wound breakdown, itching, and body image and caregiver skills. We’ll learn about some of the wounds encountered in Palliative care such as Kennedy Terminal Ulcer, Marjolin, Kaposi Sarcoma, Fungating wounds, pressure ulcers, and fistulas. The session will provide you with knowledge on topical products and interventions you can utilize for palliative wound management

For more information about the Wound Care Education Institute, please visit http://www.wcei.net.

Wound Assessment Basics : Parts 1,2, and 3 will be presented at this year’s Wild on Wounds National Conference in Las Vegas NV at Caesars Palace by Nancy Morgan RN, BSN, MBA, WOCN, WCC, CWCMS and Co-Founder of WCEI.

The basics are often forgotten. At times, we need a refresher to take us back to the basics. Join us in this 3-part session as we identify wound etiology and discuss tissue types. We’ll revisit the 2007 Pressure Ulcer Staging Guidelines and address pressure ulcer staging. But we won’t stop there, as we look at skin lesions, discuss wound pain-and no assessment is complete without proper documentation. We’ll talk about the requirements for proper documentation.

How are your Wound Assessment and Documentation skills? Need a Refresher?

The Buzz Report will be co-presented by WCEI Co-Founders Nancy Morgan RN,BSN,MBA,WOCN,WCC,CWCMS and Donna Sardina RN,MHA,WCC,CWCMS at this year’s Wild on Wounds National Convention in Las Vegas NV at Caesars Palace. This session will be presented on Thursday September 8,2011 form 9:45 a.m.-12:00 p.m.

This is the Highlight of every WOW (Wild on Wounds)! This session is your source for the latest breaking wound care news: Whats New! Whats Now! Whats Coming Up!

Donna and Nancy, WCEI Co-Founders, will bring you up-to-date on all things buzzable in wound care-new products, guidelines, resources and tools. (Note: This session includes various brand name reviews).

http://www.wcei.net The Wound Care Education Institute’s Nancy Morgan RN, BSN, MBA, WOCN, CWON, WCC, CWCMS, and Donna Sardina RN, MHA, WCC, CWCMS were recently interviewed on BlogTalkRadio.com. Listen in above to the interview to get a sneak peak at what is in store for the upcoming Wild On Wounds National Seminar September 23-25, 2010 in Las Vegas NV.

The Wild on Wounds National Convention is coming up September 23-25, 2010 in Las Vegas. Continuing in our session highlights, Basic Wound Care Applications is a session that will be presented by Nancy Morgan RN, BSN, MBA, WOCN, CWCN, WCC, CWCMS and Co-Founder of WCEI.

Learn to “Dress for Success” with the BASIC but comprehensive review of topical wound management products. This session will focus on the basic dressing categories and review what, why, when and how to apply these products. The course is ‘hands on’ with free product samples and live video demonstrations and is designed for the beginning wound care practitioner or for those interested in learning about wound care.

http://www.wcei.net Wound Care Education Institute Co-founder Nancy Morgan RN and Instructor Cindy Broadus RN discuss a question that was emailed to WCEI about how to distinguish an Arterial Ulcer from a Venous Ulcer

For More Information about becoming Wound Care Certified and knowing how to differentiate between Arterial Ulcers and Venous Ulvers, check out http://www.wcei.net

Practicing as a Wound Care Certified nurse or professional has its challenges. Not only do we have the challenge of taking care of complex patients and the wounds they incur. We also have the challenge of protecting ourselves through proper and defensive documentation. We should always document the services we are providing accurately. We should always be taking credit for the services we provide and thus properly documenting is defensive documentation. Far too often we become complacent in our day to day jobs and say to ourselves “I’ll just document that later”. Sometimes that “later” becomes never! We should all practice good documentation habits, not only for reimbursement purposes, but for defensive purposes. Below is a short video in which Cindy Broadus RN and Nancy Morgan RN discuss the importance of defensive documentation.